Cavernous oxygen tension in the patients with erectile dysfunction.

We designed a study consisting of 27 consecutive patients with erectile dysfunction in order to evaluate the role of cavernous oxygen tension. Patients were completely evaluated by history, physical examination, multiple blood analyses, serum testosterone level measurements, papaverine test, color duplex sonography and dynamic infusion cavernosometry-cavernosography. Blood gas samples were obtained from femoral artery and corpus cavernosum before drug injection and also from corpus cavernosum at 5, 10, 20, 30, 40 min following drug injection. Aetiologic classification of erectile dysfunction in our patients was as follows: psychogenic in 8, cavernosal failure in 14 and arterial disease in 5 cases. At flaccidity, no significant differences were found in the mean pO2, sO2, pCO2 and pH values of patient groups. After injection of intracavernous papaverine, results of the cavernous pO2 (P < 0.05), sO2 (P < 0.05) levels were found to be statistically significantly different between patients with vascular and psychogenic erectile dysfunction. Analysis of maximal cavernosal oxygen tension and PSV revealed statistically significant correlation (r = 0.66, P < 0.001). The results of this study suggest that changes in arterial and cavernosal pO2 and sO2 values may be contributing factors or co-factors in erectile failure.

Effect of intracavernosal sodium nitroprusside in impotence.

Recent studies have shown an important role for nitric oxide (NO) in cavernous smooth muscle relaxation. In this study the intracavernosal effects of the NO donor sodium nitroprusside (SNP) were investigated in 32 patients with erectile dysfunction. Erectile response and penile blood flow were investigated following intracavernosal administration of 360 micrograms SNP and 60 mg papaverine for diagnostic purposes. In all of 32 patients the erectile response to SNP was not better than that to papaverine. Haemodynamic evaluation of the deep penile arteries was carried out by colour duplex Doppler sonography after administration of SNP and papaverine. No differences in peak flow velocities were measured, but the increases in diameter and end-diastolic velocities were higher after SNP than after papaverine. Our data suggest that the NO donor SNP is not a new alternative agent for diagnosis and treatment of impotence.